acute congestive heart failure

Question 1

causes of pulmonary oedema

Answer 1

congestive heart fialure
acute lung injury
fluid overload kidney injury
fluid overload from IV fluid admin

Question 2

classification of heart failure

Answer 2

NYHA
new york heart association clinical classifcation of heart failure

patient symptoms + objective assessment

Question 3

symptoms of heat failure

Answer 3

SOB
cyanosis
pink frothy sputum
chest pain
cool peripheries
peripheral oedema
distressed

Question 4

signs of heart failure

Answer 4

tachypnoea
low O2 sats
use of accessory muscles
dullness to percussion at lung bases
wheeze
reduced air entry at lung bases 
inspiratory crackles
pale
hypotension
tachycardia
raised JVP
triple/gallop rythmn

Question 5

if signs of congestion on exmaination of heart fialure - what investigations

Answer 5

ABG

CXR

Question 6

findings of CXR on heart failure

Answer 6

cardiomegaly
fluffy blateral shadowing - bat wings
kerly B lines
pleural effusion

Question 7

blood tests for heart fialure

Answer 7

FBC
U+Es
LFTs
TFTs
Glucose
Troponin and BNP

Question 8

IMMEDIATE management of heart failure

Answer 8

furosemide 20-40mg IV
consider CPAP
do not routinely offer opiates or nitrates (senior review if required)
ECHO

Question 9

referrals for heart failure

Answer 9

discuss senior member
contact critical care outreach team
referral to cardiologist
ICU consideration

Question 10

further management of heart failure

Answer 10

review by cardiologist

beta blocker, ACEi, mineralcorticoid receptor antagonist (spironolactone)

cardiac rehab